Drinking Games and College Students Part 1: Problem Description

Addressing psychiatric and psychosocial issues related to children and adolescents Youth in Mind Teena M. McGuinness, PhD, CRNP, FAAN, Section Editor © 2009 iStockphoto/Roman Pyatyntsev Drinking Games and College Students Part 1: Problem Description

Abstract College students seek peer acceptance and op- drinking behavior called drinking games. Re- portunities for social interaction. For many, it gardless of the game type, the goal of this be- may be the first time away from home, away havior is to become intoxicated in a short peri- from the supervision and watchful eyes of par- od of time. Significant consequences and harm ents and other family members. Whether for can result from this dangerous social behavior. fun, thrill, competition, or the need to socialize This article, the first of two parts, will describe with others, approximately two thirds of U.S. the problem; Part 2 will discuss the implications college students participate in the risky binge for community and mental health nurses.

Nancy R. Ahern, PhD, RN; and Mary Lou Sole, PhD, RN, CCNS, FAAN, FCCM

Journal of Psychosocial Nursing • Vol. 48, No. 2, 2010 17 Youth in Mind

ing pong, card games, sumption of five or more drinks skills, team, and verbal skills games checkers, and word games at least once during the past 2 (Table). All of the games described Pare safe ways to socialize in weeks), and heavy and frequent are designed to cause intoxication the college environment, right? (i.e., five or more drinks at least in the shortest period of time. Hardly! Often, these games are once and three or more days of combined with drinking and alcohol consumption during What Are the Motivators to promote risky behavior. Drink- the past 2 weeks). Agencies, Participate? ing games are popular on college organizations, and academic in- Motivation to participate in, campuses, with reports of 47% to stitutions may use any of these avoid, or stop playing drinking 62% of college student partici- or other definitions to describe games are not well researched. Reasons for participation include competition and thrills, confor- Peer influences also mity, novelty, desire for a sexual increase the likelihood encounter, fun and celebration, relaxation, and boredom (Borsa- of participation in drinking ri, 2004; Borsari, Bergen-Cico, & games..., which may explain why Carey, 2003; Johnson & Sheets, 2004; Zamboanga, Rodriquez, students who live on campus may be & Horton, 2008). Students stop at a greater risk for participation. playing drinking games for many reasons: They get too drunk, sick, or bored, or are influenced by pation (Borsari, 2004). Drinking heavy or binge drinking. Re- others who choose to quit (John- games are appealing because they gardless, these dangerous drink- son, 2001). Students abstain promote social interactions and ing behaviors put college youth from drinking games because of provide opportunities for compe- at great physical and mental negative views of alcohol, so- tition (Borsari, 2004). Although health risk. Collaborative ap- cial isolation, unfamiliarity with the specific game, grade level of proaches for solutions must the games, past bad experiences student, and type of alcohol con- include continued research, with drinking, or personal choice sumed may vary, participants of evidence-based practice guide- (Johnson & Cohen, 2004). Moti- drinking games often become in- lines, college health programs, vations to play, stop, or not begin toxicated quickly. social policy initiatives, and at all offer clues to the develop- Many students meet the cri- community action. ment and implementation of in- teria for heavy episodic drink- Reducing drinking-related terventions aimed at preventing ing (i.e., consuming four or morbidity and mortality of this risky behavior. more drinks in a row [women] U.S. college students has been or five or more drinks in a row a national priority since the Who Is at Risk? [men] during the past 2 weeks) late 1990s. In 2002, the Na- Although there is little evi- (Wechsler, Davenport, Dowell, tional Advisory Council of the dence in the literature to ex- Moeykens, & Castillo, 1994) or NIAAA task force published plain motivators to participate binge drinking (i.e., a drinking A Call to Action: Changing the or not, there has been consider- pattern that results in a blood Culture of Drinking on U.S. Col- able research to determine the alcohol concentration of 0.08% lege Campuses. Several programs populations at risk. Of great risk or higher) (National Advisory were initiated as a result of this are those who began drinking Council on Alcohol Abuse and publication; however, results between ages 14 and 16 (Borsari Alcoholism [NIAAA], 2002). have been mixed (National In- et al., 2003). College students Drinking behavior has also been stitutes of Health, 2007). at high risk include athletes defined using the categories of (Grossbard, Geisner, Neighbors, heavy and frequency. Using these What are Drinking Kilmer, & Larimar, 2007; Zam- two categories, Presley and Pi- Games? boanga et al., 2008), fraternity mentel (2006) grouped student Drinking games can be or- and sorority members (Capone, drinkers into three categories of ganized into six categories: con- Wood, Borsari, & Laird, 2007), risk: nonheavy, heavy (i.e., consumption, gambling, media, motor and those who abuse drugs (in-

Table Drinking Game Categories, With Descriptions and Examples Category Description Examples Consumption No strategy or rules except that the player drinks as much • 100 minute club (i.e., one shot (or endurance) as possible in the shortest time. per minute for 100 minutes) games • Chug-offs • Shotguns • Beer bongs • 100 beer club • Power hour Gambling games Use of cards or dice and based on chance. Losers must • Three man drink a designated amount. Games of chance increase the • Up and down the river risk of becoming intoxicated. • Presidents • Kings • Beer checkers • Beer hunter Media games Players are cued to drink by a certain television show, • Hi Bob (i.e., player drinks when video, movie, or song. any performer on The Bob Newhart Show says “Hi, Bob”) • Have a drink on me, Roseanne Motor skills games Certain motor skills are to be performed. Failure to • Quarters (i.e., toss quarter into perform results in forced drinking. shot glass) • Cardinal puff • Chandeliers • Thumper Team games Two or more teams compete with each other. Most • Beer pong (or Beirut) popular game involves playing ping pong in some fashion • Speed with the addition of beer. Games stimulate competition. • Flip cup (i.e., sports-like competition) Verbal skills games Long or difficult words and phrases are repeated; if errors • Animal are made, the player drinks; if the round is error free, the • Add-a-word task increases in difficulty. • Fuzzy duck • The name game • Never have I ever

Sources. Borsari (2004); Zamboanga, Calvert, O’Riordan, and McCollum (2007).

cluding over-the-counter medi- ing and themed parties, create What Are the Potential cations) (Simons et al., 2005). an environment conducive to Harms and Consequences? Peer influences also increase the drinking games. Although an Drinking game participation in- likelihood of participation in extreme example, anyone who creases the risk for students to ex- drinking games (Borsari & Car- has viewed the popular movie perience associated alcohol-related ey, 2001), which may explain Animal House (Reitman, Sim- harms and consequences (Borsari, why students who live on cam- mons, & Landis, 1978) will re- 2004). Games encourage heavy al- pus may be at a greater risk for member the drinking behaviors cohol consumption in a relatively participation (Sharmer, 2005). portrayed by actor John Belushi short period of time and thus are In addition, holidays and college at the fraternity house “toga associated with consequences that events, such pregame tailgat- party.” occur with binge drinking. Harmful

Journal of Psychosocial Nursing • Vol. 48, No. 2, 2010 19 Youth in Mind

short-term consequences include Borsari, B., & Carey, K.B. (2001). Peer Reitman, I. (Producer), Simmons, M. influences on college drinking: A (Producer), & Landis, J. (Direc- driving while under the influence, review of the research. Journal of tor). (1978). Animal house [Motion risky sexual behaviors, illicit drug Substance Abuse, 13, 391-424. picture]. United States: Universal use, violence, and even death due Capone, C., Wood, M.D., Borsari, B., Pictures. to alcohol intoxication (Hing- & Laird, R.D. (2007). Fraternity Sharmer, L. (2005). Campus living ar- son, Heern, Winter, & Wechsler, and sorority involvement: Social rangements as a risk factor for par- influences, and alcohol use among ticipation in drinking games among 2005). Many factors may influence college students: A prospective ex- undergraduates. Journal of College the potential negative effects of the amination. Psychology of Addictive and University Student Housing, alcohol (e.g., amount and type of Behaviors, 21, 316-327. 33(2), 37-43. alcohol, length of time of drinking Grossbard, J., Geisner, I.M., Neighbors, Simons, L., Klichine, S., Lantz, V., episode). Long-term consequences C., Kilmer, J.R., & Larimar, M.E. Ascolese, L., Deihl, S., Schatz, B., (2007). Are drinking games sports? et al. (2005). The relationship be- are those associated with contin- College athlete participation in tween social-contextual factors and ued alcohol use and abuse. Heavy drinking games and alcohol-related alcohol and polydrug use among drinking can cause academic prob- problems. Journal of Studies on Alco- college freshmen. Journal of Psycho- lems such as missed classes and hol and Drugs, 68, 97-105. active Drugs, 37(4), 415-424. assignments, failed examinations, Hingson, R., Heern, T., Winter, M., Wechsler, H., Davenport, A., Dow- & Wechsler, H. (2005). Magni- ell, G., Moeykens, B., & Castillo, and further unsuccessful school tude of alcohol-related mortality S. (1994). Health and behavioral performance. Of serious concern, and morbidity among U.S. college consequences of binge drinking in students who participate regularly students ages 18-24: Changes from college: A national survey of stu- in drinking games may develop a 1998-2001. Annual Review of Public dents at 140 campuses. Journal of the pattern of heavy drinking that can Health, 26, 259-279. American Medical Association, 272, Johnson, T.J. (2001). College students’ 1672-1677. be carried through the college years self-reported reasons for why drink- Zamboanga, B.L., Calvert, B.D., and into early adulthood. ing games end. Addictive Behaviors, O’Riordan, S.S., & McCollum, E.C. 27, 145-153. (2007). Ping-pong, endurance, card, Summary Johnson, T.J., & Cohen, E.A. (2004). and other types of drinking games: This article, the first of two, College students’ reasons for not Are these games of the same feath- drinking and not playing drinking er? Journal of Alcohol and Drug Edu- describes the risky binge drink- games. Substance Use and Misuse, cation, 51(2), 26-39. ing behavior called drinking 39, 1137-1160. Zamboanga, B.L., Rodriquez, L., & Hor- games and the serious conse- Johnson, T.J., & Sheets, V.L. (2004). ton, N.J. (2008). Athletic involve- quences faced by U.S. college Measuring college students’ motives ment and its relevance to hazard- students who engage in such for playing drinking games. Psychol- ous alcohol use and drinking game ogy of Addictive Behaviors, 18, 91- participation in female college ath- behavior. Although this dis- 99. letes: A preliminary investigation. cussion did not include inter- National Advisory Council on Alcohol Journal of American College Health, national research findings, this Abuse and Alcoholism. (2002). A call 56, 651-656. risky behavior does not appear to action: Changing the culture of drink- to be exclusive to American ing at U.S. colleges (NIH Publication No. 025010). Retrieved from http:// Dr. Ahern is Assistant Professor, and college students. Part 2—to be www.collegedrinkingprevention. Dr. Sole is Professor, College of Nursing, published in the April 2010 is- gov/NIAAACollegeMaterials/ University of Central Florida, Orlando, sue—will include implications TaskForce/TaskForce_TOC.aspx Florida. National Institutes of Health. (2007). The authors disclose that they have for community and mental no significant financial interests in any health nurses. What colleges need to know now: An update on college drinking re- product or class of products discussed search (NIH Publication No. 07- directly or indirectly in this activity, References 5010). Retrieved from http://www. including research support. Borsari, B. (2004). Drinking games in collegedrinkingprevention.gov/ Address correspondence to Nancy the college environment: A review. 1College_Bulletin-508_361C4E.pdf R. Ahern, PhD, RN, Assistant Professor, Journal of Alcohol and Drug Educa- Presley, C.A., & Pimentel, E.R. (2006). University of Central Florida, College tion, 48, 2694-2705. The introduction of the heavy and of Nursing, 4000 Central Florida Borsari, B., Bergen-Cico, D., & Carey, frequent drinkers: A proposed clas- Boulevard, PO Box 162210, Orlando, K. (2003). Self-reported drinking- sification to increase accuracy of FL 32816-2210; e-mail: nahern@mail. game participation of incoming col- alcohol assessment in postsecondary ucf.edu. lege students. Journal of American education settings. Journal of Studies Posted: January 22, 2010 College Health, 51, 149-154. in Alcohol, 67, 324-331. doi:10.3928/02793695-20100108-03

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